Obtaining Preauthorization for Workers' Compensation Medical Treatment

If you are a medical provider needing preauthorization for a non-emergency healthcare service or treatment, please follow these steps.

Review preauthorization list

Review the list of treatments requiring approval before rendering care:

• Treatments requiring approval for Alliance providers (go to Appendix 1, which begins on page 31 of the document)
• Treatments requiring approval for non-Alliance Providers

Complete request form

Submit the appropriate request form:

• Preauthorization for health care services
• Preauthorization for prescription drugs

Fax the request form with supporting clinical documentation to 888.777.8272.

If you have questions, please call 800.482.7276.